It’s well known that some people are genetically at higher risk for the condition, but not everyone in this category actually develops the disease. No matters what your genetic risk level is, it takes some combination of life events — from gluten exposure to stress on your immune system — to activate the autoimmune attack that defines celiac disease.

Now, researchers at McMaster University in Canada have identified a factor in celiac disease that hasn’t been explored in studies before: trauma during childhood.

There were 44 adult participants in the study, including 25 people with celiac disease and 19 members of a control group with a similar balance of age and sex as the celiac group. Each participant completed a questionnaire on adverse events in early childhood, as well as one on current digestive symptoms.

The researchers found that people with celiac disease reported significantly more adverse events during childhood than those in the control group. The most commonly reported events were substance abuse in family members and neglectful parenting.

On average, people in the celiac disease group reported 7 early adverse events, while those in the control group reported only 3.

When looking at a possible link between childhood trauma and current digestive symptoms, though, the researchers found only a weak connection. There was a moderate connection between early adverse events and current severity of constipation. But no connection was found between childhood trauma and current diarrhea, abdominal pain or celiac symptoms outside the digestive tract.

The researchers noted that these results suggest a link between trauma during childhood and later develop celiac disease, although more research is needed to understand the mechanisms involved. The findings also show that people who are diagnosed with celiac disease might benefit from a psychological assessment to help their doctors learn about any trauma that contributes to symptoms.